Tips to tackle post partum depression

In our country childbirth is a much-celebrated event. It is always hard to accept mental illness especially following moments of jubilation. It’s not surprising that it gets brushed off and ignored until it takes gigantic proportions. The constant visits by relatives , the customary celebrations further prevents one from coming to terms with this pathology.Most women would accept some kind of post-partum blues but do not acknowledge it. And few understand that it might be totally unrelated to some discordancy in the family. It just happens to some predisposed women and till date we have not been able to actually understand it.
The correct word is now peripartum depression as it refers to a mood disorder that begins during pregnancy or within 4-8 weeks of delivery. It can be as severe when it is called as postpartum psychosis, and can endanger the life of the women and the baby.

Prevention should begin in the preconception phase. Programs combining depression screening with adequate support system in place improve outcome. Aim should be to modify biomedical, behavorial and social risks to a woman’s health. Any psychiatric illness if present should be managed and patient counselled accordingly
Unintended pregnancies increase the risk of postpartum depression hence it is important to teach women about contraception & family planning.
Obesity, hypothyroidism. Vit D deficiency , smoking, alcohol and substance abuse, domestic violence, relationship discord, sedentary lifestyle are high risk factors to developing any mood or psychiatric illness and should be corrected

Use of Omega 3 fatty acids, folic acid and Vitamin D supplementation has also been reported to decrease the risk of postnatal depression.
Attending antenatal classes where women are taught not just about pregnancy but also about the physical and mental changes during pregnancy and after delivery is very important. Breast feeding and child rearing should also be introduced during these classes.
Several ritualistic beliefs like keeping the woman in seclusion with a baby who just keeps crying or demanding milk and is cranky most of the times just to ward off bad spirits, making her sleep alone usually without her husband, following food fads and making her eat not her usual meals for fear of causing harm to mother and baby, not allowing enough of water all aggravates the risk to post partum depression .
It’s alright to feel a little tired , irritated because of lack of sleep. But that’s where the role of the husband and family member come in. House work along with baby care must be shared.

A refreshing sleep is the most important prevention. A good healthy diet, eating in moderation, moderate exercises, medication & stress reduction also play very important role.
It is very important to rest but then one must also get back to the routine which includes sitting with everyone , eating with everyone, talking to people, reading or listening to music , and even going out with husband on a drive. It’s a changing phase of life and should be treated as normally as possible but yes with lots of support. In west where there are single mothers , there are incidences of women throwing a crying baby to the floor frustrated when the baby does not stop crying or take feeds well. That’s shows the significance of good family support.
Any sign of distress, diffidence or depression should be recognized and medical care sought to prevent harm to both mother and baby.
(Dr. Tripti Sharan, Director - Obstetrics & Gynaecology, BLK-Max Super Speciality Hospital, Delhi)